Pancreatic cancer, body mass index and calories

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Hi All,

It seems that CR benefits males for pancreatic cancer avoidance. The case for

body

mass index appears to be greater. See the pdf-available paper excerpts below.

Eberle CA, Bracci PM, Holly EA.

Anthropometric Factors and Pancreatic Cancer in a Population-based Case-control

Study in the San Francisco Bay Area.

Cancer Causes Control. 2005 Dec;16(10):1235-1244.

PMID: 16215874

.... population-based case-control study of adenocarcinoma of the exocrine

pancreas

(532 cases, 1701 frequency-matched controls) ... Odds ratios were elevated for

body

mass index (BMI) at age 25 years (4th versus 1st quartile: odds ratio (OR) =

2.0,

95% confidence interval (CI): 1.4-3.1), maximum BMI (OR = 1.8, 95% CI: 1.2-2.7)

and

usual adult BMI (OR = 2.1, 95% CI: 1.4-3.2) among men. Odds ratios were elevated

for

increased caloric intake among men (4th versus 1st quartile: OR = 2.6, 95% C:

1.7-3.8). Increased physical activity was suggestive of decreased risk in men

and

women although CIs included unity. Our results suggest that increased BMI and

caloric intake are associated with pancreatic cancer among men.Conclusions:

These

results are consistent with other cancer studies and support further research to

determine the mechanism by which increased BMI may influence the development of

pancreatic cancer.

.... Pancreatic cancer represents the fourth leading cause of

cancer-related mortality among adult men and the & #64257;fth

among adult women in the United States (US)[1 ].In

2005,an estimated 32,180 new cases and 31,800 deaths

due to this disease are expected in the US [1 ].Only about

50%of patients survive four or more months and less

than four percent survive & #64257;ve years [2 ]. ...

.... Energy or total caloric intake is intimately related to

BMI and physical activity.Most studies have reported a

positive association between pancreatic cancer and total

energy intake for men and women [16,22-24 ]with one

study also reporting interaction between these factors

[16 ].In contrast,others have reported an inverse asso-

ciation between energy intake and pancreatic cancer [34,

35 ].However,this inverse association may re & #64258;ect a

higher energy intake associated with higher energy

expenditure or greater physical activity.Such evidence

indicates the need to assess physical activity and energy

intake comprehensively in epidemiologic studies.

Recent results suggest that impaired glucose metab-

olism,insulin resistance,and hyperinsulinemia may be

important in the pathogenesis of pancreatic cancer

[17-19,36 ].Elevated BMI,physical activity,and diet all

are important determinants of circulating insulin levels

[37-40 ].These data,combined with the increasing

prevalence of overweight and obese children and adults

in the US and other westernized countries,emphasize

the need to understand how these conditions may a & #64256;ect

pancreatic cancer development [41-43 ]. ...

.... ORs for pancreatic cancer were increased for the 4th quartile of

caloric intake among both men and women but were

statistically signi & #64257;cant among men only (men 4th quar-

tile OR =2.6,p for trend <0.0001;Table 2). ...

.... Table 2.Odds ratios (OR)and 95%con & #64257;dence intervals (CI)for

pancreatic

cancer associated with physical activity,and total caloric intake among men and

women,San Francisco Bay Area,California

===============

Men Women

Cases (N =291) Controls (N =883) OR a 95%CI Cases (N =241, n) Controls (N

=818,

n) OR a 95%CI

==============

Physical activity b

Inactive 108 279 1.0 Referent 88 273 1.0 Referent

Low 68 203 0.90 0.62-1.3 63 197 1.0 0.71-1.5

Moderate 62 207 0.91 0.61-1.3 43 165 0.91 0.60-1.4

High 53 194 0.78 0.52-1.2 47 183 0.84 0.56-1.3

Missing 0 0 0 0

p for trend 0.27 0.36

Caloric intake quartiles c (kcal/day)

1 47 221 1.0 Referent 59 205 1.0 Referent

2 63 221 1.3 0.88-2.0 57 204 0.96 0.64-1.5

3 55 221 1.2 0.75-1.8 51 205 0.86 0.56-1.3

4 123 220 2.6 1.7-3.8 70 204 1.2 0.80-1.8

Missing 3 0 4 0

p for trend <0.0001 0.48

=============

a All ORs are adjusted for age.

b Inactive=less than once a month or never;Low,1-4 times/month;Moderate,2-3

times/week;High,daily or almost daily;ORs for men ’s

physical activity are adjusted for age,education and cigarette smoking status.

c Quartile cutpoints for caloric intake (kcal/day)for men:<1545.28,1545.28 to

<1925.03,1925.03 to <2365.35,and =/>2365.35;for women:

<1334.38,1334.38 to <1695.86,1695.86 to <2116.44,and =/>2116.44.

.... Table 3.Odds ratios (OR)and 95%con & #64257;dence intervals (CI)for

pancreatic

cancer associated with anthropometric factors among men and women,San Francisco

Bay

area,California

============

Factor:Tertiles or Quartiles Men Women

Cases (N =291) Controls (N =883) OR a 95%CI Cases (N =241, n) Controls (N

=818,

n) OR a 95%CI

==============

Height (cm) b

1 92 274 1.0 Referent 98 302 1.00 Referent

2 116 329 1.0 0.76-1.4 61 226 0.89 0.62-1.3

3 83 280 0.86 0.61-1.2 82 290 1.0 0.71-1.4

Missing 0 0 0 0

BMI at 25 years c

1 44 224 1.0 Referent 54 198 1.0 Referent

2 76 225 1.7 1.1-2.6 50 207 0.88 0.57-1.4

3 79 213 1.8 1.2-2.8 64 201 1.2 0.77-1.7

4 91 220 2.0 1.4-3.1 72 211 1.3 0.84-1.9

Missing 1 1 1 1

p for trend 0.001 0.13

Maximum BMI d

1 49 207 1.0 Referent 69 204 1.0 Referent

2 58 221 1.1 0.73-1.7 48 208 0.67 0.44-1.0

3 90 237 1.6 1.1-2.4 60 201 0.87 0.58-1.3

4 94 218 1.8 1.2-2.7 63 200 0.94 0.63-1.4

Missing 0 0 1 5

p for trend 0.0006

Usual adult BMI e

1 48 222 1.0 Referent 67 197 1.0 Referent

2 70 223 1.6 1.04-2.5 51 208 0.72 0.47-1.1

3 75 214 1.6 1.1-2.5 62 208 0.86 0.58-1.3

4 95 221 2.1 1.4-3.2 61 198 0.91 0.61-1.4

Missing 3 3 0 7

p for trend 0.0007

Percent change in weight f

1 75 217 1.0 Referent 59 202 1.0 Referent

2 60 223 0.77 0.52-1.1 63 196 1.1 0.73-1.6

3 63 223 0.82 0.56-1.2 68 210 1.1 0.75-1.7

4 90 217 1.2 0.85-1.7 50 198 0.87 0.57-1.3

Missing 3 3 1 12

Percent change in weight at age 25 g

1 23 70 0.93 0.54-1.6 23 70 1.0 0.59-1.8

2 77 208 1.0 Referent 59 183 1.0 Referent

3 56 197 0.77 0.52-1.1 54 175 0.95 0.62-1.5

4 56 204 0.75 0.50-1.1 48 179 0.84 0.55-1.3

5 76 200 1.0 0.72-1.5 56 303 0.86 0.57-1.3

Missing 3 4 1 8

================

a All ORs adjusted for age.

b Quartile cutpoints for height in cm for men:<175.3,175.3 to <182.9,and

=/>182.9;for women:<162.6,162.6 to <167.6,and =/>167.6;ORs for women ’s height

are

adjusted for age and education.

c Body mass index (BMI)at 25 years based on recall of weight at 25 years of age

and

adult height;quartile cutpoints for BMI at 25 years for men:<20.9,20.9 to

<22.8,22.8

to <24.7,and =/>24.7;for women:<19.7,19.7 to <21.0,21.0 to <22.5,and =/>22.5.

d Maximum BMI based on recall of lifetime maximum weight and adult

height;quartile

cutpoints for maximum BMI men:<25.1, 25.1 to <27.1,27.1 to <30.1,and

=/>30.1;women:<23.8,23.8 to <26.6,26.6 to <30.2,and =/>30.2.

e BMI based on self-reported usual adult weight and height;quartile cutpoints

for

usual BMI for men:<23.1,23.1 to <25.1,25.1 to <27.1,and =/>27.1;for

women:<21.5,21.5

to <23.4,23.4 to <25.8,and =/>25.8.ORs for men ’s usual BMI are adjusted for age

and

cigarette smoking status.

f Percent change in weight was computed as:[(lifetime maximum weight-usual adult

weight)/usual adult weight] × 100;quartile cutpoints for percent change in

weight

for men:<4.8,4.8 to <8.3,8.3 to <14.1,and =/>14.1;for women:<5.7,5.7 to

<11.1,11.1

to <20.4,and =/>20.4.

g Percent change in weight was computed as:[(usual adult weight-weight at age

25)/weight at age 25 ] × 100;cutpoints for percent change in weight from weight

at

age 25 for men:<0,0 to <4,4 to <10,10 to <18,and =/>18;for women:<0,0 to <5,5 to

<11,11 to <19,and =/>19.

.... Physical activity and

total caloric intake were neither confounders nor effect

modi & #64257;ers of the association between BMI and pancreatic

cancer in our study ...

Al Pater, PhD; email: old542000@...

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